Our rapidly aging population will result in an increasing number of people at risk for loss of independence through dementia, frailty and other syndromes of aging. Evolving sensor and other technologies now provide a means of early detection and intervention minimizing morbidity and cost. We hypothesize that integrated, continuous and unobtrusive home monitoring of activity (motor and cognitive) can detect transitional or early signal events important for maintaining cognitive and physical health. To test our hypothesis and to further develop the resulting new clinical paradigm, lead institution Oregon Health &Science University (OHSU) will establish a novel Bioengineering Research Partnership (BRP) including OHSU's Layton Aging and Alzheimer's Disease Center, Biomedical Engineering Department, and Roybal Center, and industry partners Spry Learning, Elite Care, Pultronics, HomeFree, General Electric, Hewlett Packard and Intel. The overall effort will be led by Jeffrey Kaye of the OHSU Layton and Roybal Centers, along with bioengineering Lead Investigators Michael Pavel and Tamara Hayes. Lead Investigator, Eric Dishman from Intel will provide technology industry expertise and integration in concert with leaders from the other partners. This BRP will be dedicated to developing and testing in real world environments unobtrusive intelligent systems for integrating activities and clinical status and ultimately providing the key feedback necessary for instituting appropriate health maintenance, and illness prevention or intervention strategies. Thus our specific aims are to: 1) Determine if continuous, unobtrusive monitoring of motor and cognitive activities detects incident cognitive decline in seniors living in typical community settings;2) Develop novel algorithms and assessment techniques for detecting motor and cognitive change in these community settings and in the context of the ongoing BRP, to test evolving sensor technology;and 3) Identify the monitoring needs of, and optimal communication channels, for lay individuals and health care professionals. As a result of this research this BRP will: establish a community living laboratory of homes outfitted with integrated sensing systems to determine early cognitive decline and identify the earliest points of cognitive change using this methodology;identify the optimal predictors and data fusion that will result in early detection;establish a fast track system for unobtrusively field-testing new sensor systems while an ongoing longitudinal study is conducted;and create a shared resource of data, expertise and community attitudes about the conduct and application of these continuous assessment techniques for future proactive application in health care.